MEDICARE: RYAN MICHAEL SHANER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO04748	FL

General Provider Information

NPI Number	:	1982233086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN MICHAEL SHANER DPM

Provider Business Mailing Address
First Line	:	2378 SUNSET POINT RD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33765-1430
Country	:	US
Telephone Number	:	727-797-5007
Fax Number	:	727-725-9737

Provider Business Practice Location Address
First Line	:	2378 SUNSET POINT RD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33765-1430
Country	:	US
Telephone Number	:	727-797-5007
Fax Number	:	727-725-9737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	05/04/2026

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